Introduction
The venom of the various poisonous snakes is obtained by pressing on the poison glands, the snake being pinioned or under chloroform at the time, and as the venom drops from the fangs, it is received on pulverized sugar of milk, with which it is triturated up to the 3d in the proportion of one to ninety-nine. Above this trituration it can be converted into a liquid potency by the customary method, as alcohol seems to have no bad effect on the venom above the 3d.
The bite of a venomous snake, where the fangs do not first meet with an obstacle, legging, clothing, etc., usually means death; and we use the snake poisons as medicines in many cases that except for their intervention, would result in death.
Of the many antidotes that have been recommended for the bite, I know of none that are reliable; and of the many tried, alcohol is the best known and the oftenest used. While it frequently fails, it will be well to remember if we are even called upon to use it, that the supply must be large and the amount administered unlimited, for, to effect a cure, the patient must be gotten thoroughly under the influence of it, “dead drunk,” in technical terms, and it takes a much larger quantity of alcohol to produce its physiological effects in a person who has been bitten by a poisonous snake than it would if he was in his normal condition.
Hughes considers the various phenomena of snake-bites according to their severity, and says that they “fall into three groups corresponding to three leading forms of disease.”
It will well repay you to read the article in full as found in Hughes Pharmacodynamics, as we can simply give his summing up here.
“1. In the first group the symptoms are those of direct poisoning of the nerve centres, without local inflammation or blood changes. The great shock of the poison is first felt in the centres of the cord, gradually involving those of the medulla oblongata, and lastly implicating the functional integrity of the brain; the sympathetic system (at any rate in its cardiac portion) being the last to suffer. The main effects are seen in the parts supplied from the nerves arising at the base of the brain, especially the pneumogastric.
“2. The second form of serpent poisoning which seems to obtain is the purpuric or haemorrhagic,” which we will see exemplified many times as we study the symptoms of the various snake poisons.
“3. In the third place, we have those symptoms which result from the local affection induced by the bite,” often as a malignant character, and, as Allen says, “the action of all the serpent-venoms is directly on the blood, destroying its vitality and inducing a great variety of diseases characterized by disintegration of tissue.”
Lachesis is the best known and has been more carefully proved than any of the other serpent-venoms. Hering collected the virus in Brazil, in 1828.
The first records of cases in which the remedy was tried were published in 1835 and in 1837 it was introduced into our Materia Medica.
Symptoms
Lachesis is especially suitable for people of dark complexion (88) and bilious temperament, to ailments associated with the menopause and, as Hering says, it is “better adapted to thin and emaciated than to fat persons.”
It is a left-sided remedy (125), or the troubles calling for it start on the left-side, especially in the upper portion of the body.
There are two other prominent symptoms to keep in mind; one, the extreme sensitiveness of the affected parts to touch (166), especially to light pressure, which sensitiveness is out of proportion to the severity of the disease; the other, the almost universal distress which comes during sleep and wakens the patient in agony and fright.
We must remember that this latter condition is not the simple waking in fright (81) from dreams, or with a start, for it differs from this inasmuch as whatever pain or trouble the patient has it increases during sleep and they wake, or rather the aggravation wakens, the, with their troubles increased. So pronounced is this condition, that the patient may tell you that she is afraid to go to sleep, as she wakens feeling so much worse. “They sleep into an aggravation” (Farrington). While the symptom often reads, worse on waking, it means under Lachesis, “trouble that is brought on by going to sleep at any time, day or night” (H. N. Guernsey).
There is in Lachesis extreme prostration (155) and tendency to disorganization of the blood, the blood being dark-colored and does not coagulate.
It is especially suitable for persons of a phlegmatic temperament, with a disposition of melancholia and indolence, and is useful in melancholia and religious melancholia (131), particularly in women at the climacteric, with attacks of sadness and anxiety on waking.
In the delirium from alcohol (54), and there is great aggravation in Lachesis from alcoholic drinks (5), and in the delirium during or following fevers, loquacity is usually a prominent feature (55). This loquacity differs from that of some other remedies, inasmuch as they do not confine themselves to one thought, as they do in Stramonium, for instance, but with the increased mental activity, there is a lack of mental continuity as they constantly change from one subject to another, without waiting or caring for your answer. Again, with the prostration of the remedy we may have a muttering delirium (55).
In the delirium we may have fear that they are in a strange place, with attempts to get of bed (53) so as to go home, or fear that there are robbers in the house, with desire to escape from them. Talcott tells us (neither symptom is in the Hand-book) that the Lachesis patient may “think himself under superhuman control (54), or he thinks that he is dead and that preparations are being made for a gaudy funeral.”
A symptoms spoken of by Guernsey in reference to a prominent aggravation under Lachesis, is concerning convulsions, where the “patient has none while awake, but as soon as he is asleep they appear (36).”
Amongst other things, Lachesis is a drunkard’s remedy. In addition to delirium tremens, of which we have already spoken, it is useful in sunstroke (98) and threatening apoplexy (18) in those who are in the habit of using alcoholic stimulants, when we find dark red face and cold extremities.
Lachesis is useful in meningitis (133) and in neuralgic headaches, the pain starting in the vertex and spreading over the head. The headaches are usually neuralgic, are worse in the morning on waking (95) and are accompanied by extreme sensitiveness of the affected part to touch. The pains are severe, usually worse on the left side and better from warm applications (92).
We may have neuralgic headaches where the pains seem to concentrate at the root of the nose (104), or the pain extends to the eyes and face, or even to the shoulders.
A frequent form of neuralgic headache is where the pain is located in the occiput (100) and due to cold, or draft of air blowing on the back of the head. The pain is worse, or at least is first noticed, on waking in the morning, with soreness of the occiput to touch; even the pressure of the pillow is distressing. The pain is less, or wears away during the forenoon, only to return on succeeding mornings if you do not give Lachesis.
In the eye we have dimness of vision, with black specks flickering before the eyes (77) and it is a remedy useful in muscular asthenopia (72) after diphtheria. Whenever there is photophobia, it is worse in the morning after sleeping (76).
It is a remedy to be thought of in neuralgia of the orbit, worse left, and the eye feels as if it had been squeezed. It is rarely useful in external inflammatory diseases of the eye, but it is very valuable for haemorrhages of the optic nerve and retina (77); this apoplexy may occur in persons who have no albuminuria. It not only “absorbs the haemorrhage” but “control inflammatory symptoms and diminishes tendency to retinal extravasation” (Hering).
In the ear, Lachesis is one of several remedies where the pain goes from the throat to the ear on swallowing (191). It also has deafness and dry, hard wax in the ear (65), with sensitiveness to sounds; usually these ear symptoms are associated with diseases of the throat or other parts of the
body, thus making the choice of the remedy easier and more positive.
In the nose we have epistaxis of dark blood (142), ” mostly in the morning” (Hering) (142) and Lachesis is useful in typhoid and in amenorrhoea (138) with this symptom.
In diphtheria and in ozaena (148) we have obstruction of the posterior nares, discharge of bloody matter and often soreness of the nostrils and lips.
The gums are blue, swollen and bleeding (84) and with this condition we often have a toothache which is periodic, coming on in the morning on waking and worse from eating (187) and from warm (187) or cold drinks (187).
The tongue under Lachesis is red, dry and tremulous (192). We have a red tip or a red stripe running through the center (192). It is to be thought of in paralysis of the tongue (192) when it cannot be protruded, but catches in the teeth. It is useful in ulceration (192) and for canker sores (140) on the tongue, with great sensitiveness to touch, and in aphthae (140) and gangrene of the mouth (141), with dark purple color and offensive odor.
